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Vol. 35. Issue 6.
Pages 261-266 (June 1999)
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Vol. 35. Issue 6.
Pages 261-266 (June 1999)
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Papel de la disnea en la calidad de vida del paciente con enfermedad pulmonar obstructiva crónica
The role of dyspnea in quality of life of the patient with chronic obstructive pulmonary disease
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M.T. Elías Hernández*, F. Ortega Ruiz, H. Sánchez Riera, R. Otero Candelera, R. Sánchez Gil, T. Montemayor Rubio
Servicio de Neumología. Hospital Universitario Virgen del Roctío. Sevilla
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Objetivo

Analizar la correlación existente entre calidad de vida y parámetros de función respiratoria en reposo y con el esfuerzo; disnea basal medida mediante la utilización de dos escalas: índice basal de disnea de Mahler (BDI/TDI), y escala de la Medical Research Council. Con este estudio pretendemos ver qué factor(es) tienen más impacto sobre la calidad de vida de estos pacientes.

Material y métodos

Participaron 55 pacientes diagnosticados de enfermedad pulmonar obstructiva crónica en fase estable de su patología. A todos los enfermos se les realizaron pruebas de funcion respiratoria en reposo y en esfuerzo (test de paseo con carga progresiva o shuttle walking test y prueba de esfuerzo en cicloergómetro). La calidad de vida se determino mediante un cuestionario específico para la enfermedad pulmonar obstructiva crónica, el Chronic Respiratory Questionary Disease, traducido y validado al español. La disnea basal se determinó mediante el BDI/TDI de Mahler y la escala de la Medical Research Council.

Resultados

La edad media de los pacientes fue de 63±9,5 años y el FEV, de 40±16,9. La calidad de vida global y cada uno de sus componentes, se correlacionaron significativamente con la disnea medida por las dos escalas (BDI/TDI y Medical Research Council). La correlación fue débil con los parametros de esfuerzo y no hubo correlación con los parametros funcionales en reposo. El análisis de correlación múltiple demostró que la disnea basal medida con el BDI/TDI, era el factor predictor más importante de la calidad de vida.

Conclusiones

La disnea, medida con el BDI/TDI y la Medical Research Council, tuvo las mejores correlaciones con la calidad de vida, sobre todo la valorada mediante el BDI/TDI, y se puso de manifiesto el principal factor predictor independiente de la misma. Esto indica que la disnea es el factor que mayor impacto tiene sobre la calidad de vida y que el BDI/TDI nos permite valorar la disnea basal de estos pacientes.

Palabras clave:
EPOC
Calidad de vida
Disnea
Test de esfuerzo
Objective

To analyze the correlation between quality of life and 1) lung function parameters at rest and during exercise, and 2) mean baseline dyspnea measured on two scales - Mahler's baseline dyspnea index (BDI/TDI) and the Medical Research Council (MRC) scale. We sought to observe the factor or factors having the greatest impact on the quality of life of such patients.

Material and methods

Fifty-five patients diagnosed of COPD in stable phase of disease participated. A1 underwent lung function testing at rest and during exercise (shuttle walking test with increasing loads and an exercise cycle test). Quality of life was assessed on the validated Spanish translation of the Chronic Respiratory Disease Questionnaire, which refers specifically to COPD. Baseline dyspnea was measured using Mahler's BDI/TDI and the MRC scale.

Results

Mean patient age was 63±9,5 years and FEV, was 40±16.9%. Overall quality of life and each sub-item correlated significantly with mean dyspnea on both scales (BDI/TDI and MRC). Effort was weakly correlated and function parameters at rest were unrelated. Multiple correlation analysis showed that baseline dyspnea (BDI/TDI) was the most important predictor of quality of life.

Conclusions

Dyspnea, particulary when expressed as BDI/TDI but also as measured on the MRC sclae, correlates more highly with quality of life than does any other parameter. This indicates that dyspnea has greater impact than other factor on quality of life and that BDI/TDI provides a good baseline assessment of dyspnea in COPD patients.

Key words:
COPD
Quality of life
Dyspnea
Exercise test
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Copyright © 1999. Sociedad Española de Neumología y Cirugía Torácica
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